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Prenatal ultrasound raises questions.

Ultrasound imaging during pregnancy is increasingly being done in doctor's offices. But, according to some health experts, the practice raises uncomfortable questions:

* Are tests offered in a doctor's office substandard in quality?

* Was the test necessary?

* Did it cost more than at a radiologic center?

The issues surrounding fetal ultrasound include debates over whether obstetricians are qualified to perform the exams; whether to require accreditation for anyone offering the tests; whether technicians who operate the ultrasound machines should be certified; and whether ultrasound should even be recommended. Moreover, the ethics of physicians "self-referring" patients to the doctors, own labs has come under increasing fire.

One recent study found that one-third of all facilities performing ultrasound--radiology centers and obstetricians alike--failed to meet national quality-assurance guidelines for the test, which uses sound waves to take a "picture" of the developing baby.

The study was particularly critical of the ultrasound in doctors, offices, showing that only 48 percent met quality guidelines, says a co-author of the study, Dr. Howard B. Kessler of U.S. Healthcare, a large health maintenance organization in the east.

The study, he says, should alert consumers and doctors that standards need to be enforced wherever ultrasound is offered. The tests have become enormously popular, with about 70 percent of pregnant women undergoing at least one per pregnancy to determine the fetus's age and possible problems, as well as the condition of the placenta.

Obstetricians, about two-thirds of whom have ultrasound equipment, argue that the vast majority are fully qualified to perform basic ultrasound. They defend their commitment to quality guidelines. However, the big question, experts say, is how to ensure that such tests are performed only when necessary, particularly in private offices, where control measures may be less stringent than elsewhere.
COPYRIGHT 1993 Association of Labor Assistants & Childbirth Educators
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Publication:Special Delivery
Date:Mar 22, 1993
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